A possible role for ghrelin, leptin, brain-derived neurotrophic factor and docosahexaenoic acid in reducing the quality of life of coeliac disease patients following a gluten-free diet
- 305 Downloads
A gluten-free diet (GFD) has been reported to negatively impact the quality of life (QoL) of coeliac disease (CD) patients. The gut–brain axis hormones ghrelin and leptin, with the brain-derived neurotrophic factor (BDNF), may affect QoL of CD patients undergoing GFD. Our aims were to evaluate whether: (a) the circulating concentrations of leptin, ghrelin and BDNF in CD patients were different from those in healthy subjects; (b) GFD might induce changes in their levels; (c) BDNF Val66Met polymorphism variability might affect BDNF levels; and (d) serum BDNF levels were related to dietary docosahexaenoic acid (DHA) as a neurotrophin modulator.
Nineteen adult coeliac patients and 21 healthy controls were included. A QoL questionnaire was administered, and serum concentrations of ghrelin, leptin, BDNF and red blood cell membrane DHA levels were determined at the enrolment and after 1 year of GFD. BDNF Val66Met polymorphism was analysed.
Results from the questionnaire indicated a decline in QoL after GFD. Ghrelin and leptin levels were not significantly different between groups. BDNF levels were significantly (p = 0.0213) lower in patients after GFD (22.0 ± 2.4 ng/ml) compared to controls (31.2 ± 2.2 ng/ml) and patients at diagnosis (25.0 ± 2.5 ng/ml). BDNF levels correlated with DHA levels (p = 0.008, r = 0.341) and the questionnaire total score (p = 0.041, r = 0.334).
Ghrelin and leptin seem to not be associated with changes in QoL of patients undergoing dietetic treatment. In contrast, a link between BDNF reduction and the vulnerability of CD patients to psychological distress could be proposed, with DHA representing a possible intermediate.
KeywordsBDNF Coeliac disease DHA Gluten-free diet Ghrelin Leptin Psychological distress
The authors thank Dr. Benedetta D’Attoma and Dr. Manuela Martulli (IRCCS “Saverio de Bellis”) for their precious technical assistance.
Compliance with ethical standards
Conflict of interest
CF discloses her position as partner of Lipinutragen srl. The other authors declare that they have no competing interests.
- 6.Barratt SM, Leeds JS, Sanders DS (2011) Quality of life in Coeliac disease is determined by perceived degree of difficulty adhering to a gluten-free diet, not the level of dietary adherence ultimately achieved. J Gastrointestin Liver Dis 20:241–245Google Scholar
- 7.Samasca G, Sur G, Lupan I, Deleanu D (2014) Gluten-free diet and quality of life in celiac disease. Gastroenterol Hepatol Bed Bench 7:139–143Google Scholar
- 8.Casellas F, Rodrigo L, Lucendo AJ, Fernandez-Banares F, Molina-Infante J, Vivas S, Rosinach M, Duenas C, Lopez-Vivancos J (2015) Benefit on health-related quality of life of adherence to gluten-free diet in adult patients with celiac disease. Rev Esp Enferm Dig 107:196–201Google Scholar
- 9.Nachman F, del Campo MP, Gonzalez A, Corzo L, Vazquez H, Sfoggia C, Smecuol E, Sanchez MIP, Niveloni S, Sugai E, Maurino E, Bai JC (2010) Long-term deterioration of quality of life in adult patients with celiac disease is associated with treatment noncompliance. Dig Liver Dis 42:685–691CrossRefGoogle Scholar
- 13.Riezzo G, Ferreri C, Orlando A, Martulli M, D’Attoma B, Russo F (2014) Lipidomic analysis of fatty acids in erythrocytes of coeliac patients before and after a gluten-free diet intervention: a comparison with healthy subjects. Br J Nutr 112:1787–1796. doi: 10.1017/S0007114514002815 CrossRefGoogle Scholar
- 20.Linkov F, Burke LE, Komaroff M, Edwards RP, Lokshin A, Styn MA, Tseytlin E, Freese KE, Bovbjerg DH (2014) An exploratory investigation of links between changes in adipokines and quality of life in individuals undergoing weight loss interventions: possible implications for cancer research. Gynecol Oncol 133:67–72CrossRefGoogle Scholar
- 29.Zou Y-F, Wang Y, Liu P, Feng X-L, Wang B-Y, Zang T-H, Yu X, Wei J, Liu Z-C, Liu Y, Tao M, Li H-C, Li K-Q, Hu J, Li M, Zhang K-R, Ye D-Q, Xu X-P (2010) Association of BDNF Val66Met polymorphism with both baseline HRQOL scores and improvement in HRQOL scores in Chinese major depressive patients treated with fluoxetine. Hum Psychopharmacol 25:145–152CrossRefGoogle Scholar
- 39.Russo F, Chimienti G, Clemente C, D’Attoma B, Linsalata M, Orlando A, De Carne M, Cariola F, Semeraro FP, Pepe G, Riezzo G (2013) Adipokine profile in celiac patients: differences in comparison with patients suffering from diarrhea-predominant IBS and healthy subjects. Scand J Gastroenterol 48:1377–1385. doi: 10.3109/00365521.2013.845907 CrossRefGoogle Scholar
- 49.Brown GW, Craig TK, Harris TO, Herbert J, Hodgson K, Tansey KE, Uher R (2014) Functional polymorphism in the brain-derived neurotrophic factor gene interacts with stressful life events but not childhood maltreatment in the etiology of depression. Depress Anxiety 31:326–334. doi: 10.1002/da.22221 CrossRefGoogle Scholar